血管周围间隙扩散张量成像指数在评估儿童良性Rolandic癫痫脑类淋巴系统功能及疾病状态的价值

Evaluation of glymphatic system activity and disease state by diffusion tensor image analysis along the perivascular space index in children with benign Rolandic epilepsy

目的探讨血管周围间隙扩散张量成像指数(diffusion tensor image analysis along the perivascular space index,DTI-ALPS index)在评价儿童良性Rolandic癫痫(Rolandic epilepsy,RE)患儿脑类淋巴系统(glymphatic system,GS)功能及疾病状态中的价值。材料与方法选取20例6~12岁的RE患儿(患儿组)与20例年龄、性别匹配的儿童(对照组)行常规MRI及MR扩散张量成像(diffusion tensor imaging,DTI)检查。定量分析两组的DTI-ALPS index。采用Pearson相关分析患儿组DTI-ALPS index与癫痫发作持续时间、发作频率及认知功能的相关性。结果患儿组DTI-ALPS index较对照组降低(患儿组:1.41±0.20,对照组:1.56±0.16;t=-2.620,P=0.013)。两组DTI-ALPS index均与年龄呈正相关(患儿组r=0.483,P=0.002;对照组r=0.534,P<0.001)。患儿组DTI-ALPS index与癫痫发作持续时间、发作频率呈负相关(发作持续时间r=-0.743,P<0.001;发作频率r=-0.460,P=0.044);与总智商(full intelligence quotient,FIQ)及言语智商(verbal intelligence quotient,VIQ)呈正相关(r_FIQ=0.523,P=0.014;r_VIQ=0.563,P=0.001),与操作智商(practical intelligence quotient,PIQ)无相关性。结论DTI-ALPS index可用于评估RE患儿GS功能受损情况,在探究疾病状态中具有较高的价值。

Objective:To investigate the value of diffusion tensor image analysis along the perivascular space index(DTI-ALPS index)on glymphatic system(GS)activity and disease state in children with benign Rolandic epilepsy(RE).Materials and Methods:Twenty patients aged 6-12 years with RE and 20 children matched in gender and age underwent conventional MRI and diffusion tensor imaging(DTI).Quantitative analysis DTI-ALPS index between two groups.Meanwhile,correlation of DTI-ALPS index with seizure duration,epileptic frequency and cognitive development were respectively explored via Pearson's coefficient(r).Results:Compared with control group,DTI-ALPS index was higher in control group than patient group(RE:1.41±0.20,Control:1.56±0.16;t=-2.620,P=0.013).DTI-ALPS index positively correlated with age(r_patient=0.483,P=0.002;r_control=0.534,P<0.001),full intelligence quotient(FIQ)and verbal intelligence quotient(VIQ)(r_FIQ=0.523,P=0.014;r_VIQ=0.563,P=0.001).However,DTI-ALPS index gradually decreased with seizure duration and epileptic frequency(r_seizure duration=-0.743,P<0.001;r_epileptic frequency=-0.460,P=0.044).There was no significant associations between DTI-ALPS index and practical intelligence quotient(PIQ).Conclusions:DTI-ALPS index can be used to evaluated impairment of the GS in RE,which has a good prospect for exploring the state of RE.